Patient Forms

Please plan to arrive 15 minutes early to complete the necessary paperwork. Alternatively, you can print the applicable intake forms found below to expediete this process at our office. Please bring the forms along with a picture ID and your current insurance card. 

To help us provide you with the most comprehensive healthcare possible, previous medical records are vital. Prior to your visit, please contact your last physician to obtain pap results, blood work, mammogram reports, surgery reports, obstetrical notes and any other pertinent health history.

Your records can be faxed to our office at 225-367-1108 or you can bring them with you to your appointment.

Patient Intake Paperwork

Annual Visit (New Patient Packet)

Annual Visit (Existing Patient Packet)

OB Pregnancy (New or Existing Patient Packet)

GYN (New Patient Packet)

Pellet (New Female Patient Packet)

Pellet (New Male Patient Packet)

Pellet (Existing Female Patient Packet)

Pellet (Existing Male Patient Packet)

Functional Medicine Consult (New Female Patient Packet)

Functional Medicine Consult (New Male Patient Packet)

Medical Record Requests

Authorization To RELEASE Medical Records FROM Mint Health

Authorization To SEND Medical Records TO Mint Health

Patient Instructions

Gestational Diabetes Testing and Breast Pump Instructions

How to Access Lab Results on the Patient Portal